Archives for July 2017

I’m curious to know what the dental community thinks about Aaron Judge’s case, and which, if any, direct composite veneers technique would have been best for his injury. For those unaware, Judge is a Yankees player who was injured in a post-game celebration. His tooth came into contact with a helmet and a corner of it broke off. It seems to me, that this could have been handled by the right direct composite veneers technique, had he seen a skilled cosmetic dentist. Unfortunately, it sounds like he wound up in the hands of a hack who forced him to get full coverage.

-Joseph

Dear Joseph,

It’s generally unwise to speculate with so few details being known. At this point, no details have emerged that say exactly what he had done, nor what the diagnosis was. While it’s possible he only lost a small portion of the tooth, most reports indicate he lost half, if not more. Could he have gotten by with less than full coverage? Only his dentist and those with x-rays, as well as the knowledge to interpret them know the truth.

With all that said, Judge also remarked that he felt like both his front teeth had been knocked out. That kind of trauma does usually kill the tooth, resulting in the need for a root canal at a later point in time. While there’s a benefit to being conservative, and only providing treatment known to be absolutely necessary, it’s also possible this dentist knows something the rest of us don’t. It’s entirely possible he needed one of more root canals. Although the need for crowns on anterior teeth in these circumstances is widely debated in the industry, it’s still standard practice, and it would make sense if the treating dentist included it as part of his treatment plan.

If a chairside option would have worked, and that’s a BIG if, the direct composite veneers technique that would have worked best would vary based on the dentist. However, certainly a dental matrix or a form would have been beneficial in the shaping and building process. Something like this would have worked as a long-term solution, but only if the damage didn’t require a full crown. It would have also been a viable short-term solution if the dentist wanted to do a porcelain veneer, but needed something temporary to protect the tooth and keep him looking good while he waited for the permanent porcelain veneer.

I’m wondering if there is a dental bonding technique that can be used on top of porcelain veneers to correct a gap that makes my teeth look crooked. A while back, my regular dentist put porcelain veneers on my teeth. I have no real complaints about them in terms of how they match or feel. The dentist and I talked about them at length beforehand. I actually have a gap between my two front teeth and, although I wanted my teeth to look better, I didn’t want to lose my “signature” look. I’ve had this gap all my life, so if it suddenly disappeared, everyone would know that I work done. In any case, the dentist agreed to preserve it, but he didn’t keep it even. One of the porcelain veneers hangs off to the side some, so it looks like the teeth are off center. What I’d like to do is have a little material added to the other side, so it balances out. Is there a dental bonding technique that will work for this and still provide a cohesive look, or will it look like something funky was stuck on the tooth?

Thank you,

Phillipe

Dear Phillipe,

Your situation is a tough one. To get the best results, you would want to have your porcelain veneers redone by a cosmetic dentist. However, sometimes cost and other variables makes this solution a little less viable.

There are two other primary ways you may be able to go about fixing this. The first, and probably easiest, is to see if the dentist can smooth out the side that’s too bulky. Even minor adjustments can make a huge difference. If that’s not an option, you may have some luck with some sort of dental bonding technique. It will bond to the porcelain, and it can be done up as an exact match, but it’s incredibly difficult for a dentist to do. Again, you’d want to see a cosmetic dentist for that. Moreover, porcelain and the resin used for chairside restorations tend to wear differently. You may find that, over time, the two do start to look different. You’d need to have the resin portion replaced or adjusted every time this happens. Whether it buys you a year or several years, it’s hard to gauge. Your habits will be a major determining factor. Again, your best bet is replacement, but check with a cosmetic dentist and see if he can come up with any alternatives.